FIRST NAMELAST NAMEEMAIL ADDRESSTYPEIndividualList your own income and properties.JointIncludes both persons income and properties.

ELECTRONIC RECORD AND SIGNATURE DISCLOSURE

From time to time, JJ Best Banc & Co. (or “Lender”) may be required to provide to you certain written notices or disclosures.
Described below are the terms and conditions for providing to you such notices and disclosures electronically. This E-Sign
Disclosure and Consent (this "Consent") provides the person(s) giving his/her consent ("you") with information relating to
your electronic receipt of disclosures and notices (collectively, the "Disclosures") in connection with your loan application
pending with Lender. By providing your consent, you agree that the Lender may send you any and all Disclosures relating to the
Loan Application in an electronic form.

Types of Disclosures and Notices that will be Provided in Electronic Form.
The Disclosures may include disclosures and notices under the Federal Equal Credit Opportunity Act and Regulation B, the
Federal Truth-in-Lending Act and Regulation Z, the Federal USA PATRIOT Act of 2001 and Title V of the Federal Gramm-Leach-Bliley
Act, together with all rules and regulations that implement the same, as well as all other disclosures that are required by
applicable federal, state and local laws, rules, regulations and ordinances during the mortgage loan origination process. The
Disclosures also include any other information, agreements, disclosures and notices that Lender wishes to provide you in connection
with the Loan Application in an electronic form, even if the information, agreements, disclosures and notices are not required by
these laws, rules, regulations or ordinances.

Scope of Your Consent.
Your Consent applies only to your electronic receipt of Disclosures in connection with the origination, and closing of your
Loan. Your Consent does not apply to other transactions that you may wish to enter into with us or any of our affiliates.

Your Right to Receive Paper Copies of the Disclosures. You are not required to provide your Consent in order to submit a
loan application. If you prefer not to provide your Consent, all of the Disclosures will be provided to you in paper form. To
request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you
must send us an e-mail and in the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number.

Your Right to Withdraw Your Consent.
You have the right to withdraw your Consent at any time. You will not be charged any fees as a result of the withdrawal of your
Consent. If you withdraw your Consent, any Disclosures provided to you after the effective date of the withdrawal will be
provided in paper form. You can withdraw your Consent by sending us an e-mail and in the body of such request you must state
your e-mail, full name, US Postal Address, and telephone number and a statement that you withdraw your consent tor receive
electronic disclosures. The consequences of your withdrawing consent for online documents will be that transactions may take
a longer time to process.

Change in Your Email Address.
To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must
send an email message to us and in the body of such request you must state: your previous e-mail address, your new e-mail address.

Computer Hardware, Software and Other Requirements.
You must have the following listed items and features in order to receive Disclosures electronically, to print copies of the
Disclosures, and to retain electronic copies of the Disclosures:

A personal computer with monitor, keyboard and mouse capable of accessing the Internet and sending and receiving e-mail:

One of the following Internet browsers: Chrome 31.0 or higher, Microsoft Internet
Explorer 9 or higher, Mozilla Firefox ESR and 23.0 or higher, Safari 6.1 or higher, Adobe Acrobat Reader® version 6.0 or higher,
a valid e-mail address, a printer capable of printing text screens, if you wish to print copies of the Disclosures

Acknowledging your access and consent to receive materials electronically
To confirm to us that you can access this information electronically, which will be similar to other electronic notices and
disclosures that we will provide to you, you will need to verify at the time you submit your Loan Application that you were
able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for
your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be
able to print on paper or save it for your future reference and access. By submitting your Loan Application, you consent to
receiving notices and disclosures exclusively in electronic format on the terms and conditions described above as follows:

By submitting my Loan Application, I confirm that:

I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document;

I can print the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and

Until or unless I notify Lender, I consent to receive from exclusively through electronic means all notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made available to me by Lender
during the course of my Application process.